POST-MIGRATION HEALTH AND BEHAVIOR CHANGE: MIDLIFE WOMEN

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The purpose of this prospective study is to examine the longitudinal influence of modifiable behaviors that mediate the effects of acculturation on post-migration health. The study will identify strategic points in time during which nursing interventions would be most effective for midlife immigrant women from the former Soviet Union. Immigration is a non-normative developmental transition that takes place in the context of the family system. Older age at immigration and female gender are important predictors of vulnerability. Significant deterioration in physical and psychological health has been documented cross- sectionally as duration of residence increases. Longitudinal methods have not been used, however, to systematically study the effects of acculturation and behavioral risk factors on health status. The specific aims of the study are to 1) track changes over time in acculturation, using indicators of English language usage, adoption of U.S. lifestyle, cultural identity, and acculturation attitudes; 2) track changes in modifiable behavioral mediators, including stress management resources, family adaptation, diet and physical activity; 3) track changes over time in health status, using indicators of physical and psychological health; and 4) identify background factors, acculturation characteristics, and behavioral mediators that are correlates of change in health status. Participants will include 225 women, 40 to 70 years old, who are less than 6 years post- migration at entry into the study. Data collection will include questionnaires, 24-hour dietary recalls, and physical measurements (e.g., blood pressure, serum cholesterol and percent body fat), assessed every 9 months (5 times) over 3 years. The sample will be stratified by age and duration of residence. Data analysis will employ an innovative application of hierarchical linear models to document within-individual change over time and estimate group change over the first 9 years post-migration. Prudent targeting of intervention is critical to facilitating effective allocation of health care research while improving health status for new immigrants. The resource methodology validated by this study can be applied to other populations to identify high risk periods and design multifocal programs that are age, gender and culture specific.